Glute & Piriformis Tightness: A Hidden Cause of Hip Pain, Low Back Pain, and Sciatica

drdisalvo
Nov 19
3 min read

If you’ve ever felt a deep ache in your hip, tightness in your low back, or that telltale “zing” of sciatic nerve irritation, your glutes or piriformis muscle may be the reason why. These powerful muscles play a huge role in how you move, and stabilize and support your spine and pelvis — and when they get tight or overworked, they can create big problems.

As a chiropractor who treats active adults, runners, lifters, and busy parents daily, I see this pattern all the time: glute and piriformis tightness causing pain that seems to “travel” or show up in multiple areas.

Let’s break down why it happens — and what you can do about it.

Why Glute & Piriformis Tightness Causes Pain

1. Hip Pain

When the glutes and piriformis are tight, they restrict hip rotation and mobility. This forces your hip joint to move poorly and absorb more stress than it should. Over time, this leads to pinching, stiffness, and deep buttock pain.

2. Low Back Pain

Your glutes stabilize your pelvis and support your spine during walking, running, and lifting. If they aren't doing their job because they're tight, weak, or both, your low back muscles have to pick up the slack. That extra workload leads to tension and pain in the lumbar spine.

3. Sciatica Symptoms (Piriformis Syndrome)

Your piriformis muscle sits directly over the sciatic nerve. In some cases, the sciatic nerve actually runs through the piriformis muscles. When the muscle becomes tight or inflamed, it can compress or irritate the nerve — creating symptoms like:

Sharp or burning pain down the leg to about the knee
Tingling or numbness in the glute or hamstring
Pain that worsens with sitting

This is known as piriformis syndrome, and it's incredibly common.

At-Home Fixes to Loosen Tight Glutes & Piriformis

These simple strategies can help reduce tension and improve mobility:

1. Figure-4 Stretch

Lie on your back, cross one ankle over the opposite knee, and gently pull the legs toward your chest. Hold 20–30 seconds and repeat 2–3x each side.

2. Glute Bridges

Activating the glutes can reduce strain on your low back. Try 2 sets of 10–12 reps.

3. Piriformis and Glute Mobilization with a Ball

Use a lacrosse ball or foam roller to apply gentle pressure to tight spots in the glute. This can be done seated or up against a wall. Hold 20–30 seconds per area.

4. Gentle Hip Rotations

Sitting or lying down, move the hip through internal and external rotation to improve mobility.

These can help, but if your symptoms are persistent or severe, you may need something more targeted.

How Dry Needling Helps Relieve Glute & Sciatica-Related Pain

Dry needling is one of the most effective treatments for glute and piriformis tightness. By using a very thin needle, I can reach deep trigger points and irritated tissue that hands simply can’t access.

Dry needling helps by:

Releasing muscle tension in the glutes and piriformis
Improving blood flow to promote healing
Reset neuromuscular patterns so the glutes fire properly during movement
Reducing pain quickly, often within the first couple of sessions

For many patients, dry needling provides relief they haven’t been able to get from stretching or massage alone.

Final Thoughts

Glute and piriformis tightness may seem minor, but it can be the hidden cause of hip pain, low back pain, or sciatic symptoms. The good news? It’s absolutely treatable.

If you’ve been dealing with persistent tightness, pain down the leg, or discomfort with sitting or exercise, it might be time for a thorough evaluation — and dry needling might be the missing piece of your recovery.

Dr. Allie Di Salvo is a chiropractor at The Body Remedy in Andover, MA, specializing in dry needling, sports injuries, and mobility-based care for active adults.